Intolerance of uncertainty on distress and impairment: The mediating role of repetitive negative thinking.

Repetitive negative thinking and intolerance of uncertainty are risk and maintenance factors for emotional disorders. Although emerging evidence suggests that intolerance of uncertainty predicts increases in distress through repetitive negative thinking, these relationships have yet to be investigated among veterans. The present study examines if repetitive negative thinking mediates the relationships of intolerance of uncertainty with stress, disordered symptoms and impairment among a mixed clinical sample of veterans. Two hundred and forty-four treatment-seeking veterans with diagnoses of major depressive disorder, panic disorder, or posttraumatic stress disorder completed measures of intolerance of uncertainty, repetitive negative thinking, stress, impairment, depression, panic, and posttraumatic stress prior to receiving treatment. Mediation models revealed indirect effects of intolerance of uncertainty through repetitive negative thinking on stress and impairment in the full sample, and on disordered symptoms in subsamples with major depressive disorder and posttraumatic stress disorder. Conversely, intolerance of uncertainty did not have direct or indirect effects on disordered symptoms in a panic disorder subsample. Findings suggest that repetitive negative thinking and intolerance of uncertainty uniquely contribute to stress, impairment, and disordered symptoms, but repetitive negative thinking, may, in part, drive intolerance of uncertainty's contribution to emotional disorders. Interventions for repetitive negative thinking might improve the efficacy of existing transdiagnostic treatment protocols. Cross-sectional data is a limitation of the present study. Prospective designs in civilian samples can better establish the temporality of these relationships and if they are generalizable to the larger population.

Incremental Validity of Cognitive-Behavioral Therapy and Acceptance and Commitment Therapy Mechanisms for Anxiety and Panic Symptomology.

Background: acceptance and commitment therapy (ACT) and cognitive-behavioral therapy (CBT) are empirically supported treatments for anxiety and panic disorder (PD), though they differ in their putative vulnerability and maintenance processes. The present study examined the incremental validity of several of these models' proposed core processes, including anxiety sensitivity (AS), dispositional avoidance, experiential avoidance (EA), cognitive fusion (CF), and mindfulness, as well as the interaction of the processes within each model, in the prediction of anxiety and panic symptomology. Methods: a sample of US adults (n = 316) completed self-report measures of AS, dispositional avoidance, EA, CF, mindfulness, anxiety, and PD symptoms. A series of hierarchical multiple regression analyses were conducted. Results: hierarchical regression analyses indicated that AS, dispositional avoidance, and EA predicted anxiety and panic symptoms even after controlling for one another, CF, mindfulness, and demographic variables. Although mindfulness and CF was correlated with anxiety and panic at the univariate level, they did not predict either outcome above and beyond AS, dispositional avoidance, and EA. When interaction terms were added to the models, the interaction between AS and -dispositional avoidance was a significant predictor of panic and anxiety symptoms, whereas the interaction between EA and CF only predicted panic symptoms. None of the interactions that included mindfulness were significant predictors. Conclusions: these findings provide support the independent and interactive predictive value of traditional CBT (AS, dispositional avoidance, and AS-dispositional avoidance) and ACT (EA) processes for anxiety and panic symptoms, but raise questions about the incremental predictive utility of CF and mindfulness.

Social comparisons and social anxiety in daily life: An experience-sampling approach.

Judgments about the self compared to internalized standards are central to theoretical frameworks of social anxiety. Yet, empirical research on social comparisons-how people view themselves relative to others-and social anxiety is sparse. This research program examines the nature of everyday social comparisons in the context of social anxiety across 2 experience-sampling studies containing 8,396 unique entries from 273 adults. Hypotheses and analyses were preregistered with the Open Science Foundation (OSF) prior to data analysis. Study 1 was a 3-week daily diary study with undergraduates, and Study 2 was a 2-week ecological momentary assessment (EMA) study with a clinical sample of adults diagnosed with social anxiety disorder (SAD) and a psychologically healthy comparison group. In both studies, social anxiety was associated with less favorable, more unstable social comparisons. In both studies, favorable social comparisons were associated with higher positive affect and lower negative affect and social anxiety. In both studies, social comparisons and momentary affect/social anxiety were more strongly linked in people with elevated trait social anxiety/SAD compared to less socially anxious participants. Participants in Study 2-even those with SAD-made more favorable social comparisons when they were with other people than when alone. Taken together, results suggest that social anxiety is associated with unfavorable, unstable self-views that are linked to compromised well-being. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Optimal well-being in the aftermath of anxiety disorders: A 10-year longitudinal investigation.

BACKGROUND: Although preliminary research has explored the possibility of optimal well-being after depression, it is unclear how rates compare to anxiety. Using Generalized Anxiety Disorder (GAD) and Panic Disorder (PD) as exemplars of anxiety, we tested the rates of optimal well-being one decade after being diagnosed with an anxiety disorder. Based on reward deficits in depression, we pre-registered our primary hypothesis that optimal well-being would be more prevalent after anxiety than depression as well as tested two exploratory hypotheses. METHOD: We used data from the Midlife in the United States (MIDUS) study, which contains a nationally representative sample across two waves, 10 years apart. To reach optimal well-being, participants needed to have no symptoms of GAD, PD, or major depressive disorder (MDD) at the 10 year follow-up and exceed cut-offs across nine dimensions of well-being. RESULTS: The results failed to support our primary hypothesis. Follow-up optimal well-being rates were highest for adults previously diagnosed with MDD (8.7%), then PD (6.1%), and finally GAD (0%). Exploratory analyses revealed optimal well-being was approximately twice as prevalent in people without anxiety or depression at baseline and provided partial support for baseline well-being predicting optimal well-being after anxiety. Results were largely replicated across different classifications of optimal well-being. LIMITATIONS: Findings are limited by the somewhat unique measurement of anxiety in the MIDUS sample as well as the relatively high rate of missing data. CONCLUSIONS: We discuss possible explanations for less prevalent optimal well-being after anxiety vs. depression and the long-term positivity deficits from GAD.

Do people with elevated social anxiety respond differently to digital and face-to-face communications? Two daily diary studies with null effects.

BACKGROUND: Retrospective studies have found that people with elevated social anxiety (SA) show a preference for digital/online communication, which may be due to perceptions of enhanced emotional safety. Whether these individuals prefer digital compared to face-to-face communication and experience emotional benefits naturalistically remains unclear. METHODS: We recruited college students (N = 125) and community adults (N = 303) with varying levels of SA and sampled their emotions during digital and face-to-face communication using ecological momentary assessment (EMA) (Study 1) and a day reconstruction method (DRM) (Study 2). We preregistered our hypotheses (https://osf.io/e4y7x/). RESULTS: Results from both studies showed that SA did not predict the likelihood of engaging in digital compared to face-to-face communication, and SA was associated with less positive and more negative emotions regardless of the communication medium. Study 2 showed that whether digital communication was synchronous (e.g., in real time via phone/video chat) or asynchronous (e.g., texting/instant messaging) did not impact the association between SA and emotions. LIMITATIONS: EMA and DRM methods, despite their many advantages, may be suboptimal for assessing the occurrence of digital communication behaviors relative to more objective methods (e.g., passively collecting smartphone communication data). Using event-contingent responding may have also yielded more reports of digital communication, thus strengthening our power to detect small, cross-level interaction effects. CONCLUSIONS: These results challenge beliefs that digital/online communication provides a source of emotional safety for people with elevated SA and suggests a greater need to address SA-related emotional impairments across digital communication platforms.